Author: Jake Whitacre

This post was originally featured in ARRS InPractice.

“This pandemic is really getting me down… I’m not sleeping well… Small things worry me constantly… My concentration drifts while interpreting studies… Antacids are taking care of my epigastric symptoms… Alcohol has become a necessary crutch to help me sleep… Everybody seems so needy around me… The media is driving me insane… The sense of loss overwhelms me at times… I cannot bear the thought of more Zoom meetings…”

Resilience. It’s a concept that predates the pandemic and one that we’ve heard about in personal development books, TED Talks, and leadership courses many times before. The word conjures a sense of unshakeable inner strength that’s impermeable to outside forces, like a giant African baobab tree—also known as the continent’s “tree of life”—during a torrential storm. You might define resilience as the capacity to recover and bounce back from adverse circumstances, such as those many of us are currently experiencing, as illustrated by the sampling of comments above.

It often feels like the pandemic swiftly derailed the pre-2020 tools and strategies we had introduced to our organizations to identify and combat employee burnout and support the collective health and wellness of our teams. While stressors have expanded and amplified, the concepts that were leading us on a path to healthier workplaces are still valid and valuable, particularly when it comes to resilience. With intention, practice, patience, and persistence, resilience can be learned, sustained, and strengthened; with resilience, we can emerge from our proverbial emotional basements, even during the most turbulent of weather.

Opening the Cookbook

While it’s not quite as simple as following a step-by-step recipe for your favorite meal, several key ingredients can help you develop resilience. Let’s explore 10 of them here.

1. Take care of yourself, first and foremost: If you’re a leader, remind yourself of the airline analogy to put on your own oxygen mask first. Learn to practice mindfulness to slow down and reduce anxiety. Learn to focus on being intensely aware of your senses and feelings in the moment, without interpretation or judgment. Be mindful, too, that you may be using unhelpful coping solutions. Try to eat healthily, sleep to rejuvenate, and exercise as best as you can, wisely. Doing so should boost your capacity for physical resilience. Consider strategies to boost your mental resilience, as well. How do you reignite your energy and creativity after challenging situations? Are you able to effectively disconnect? Build time into your schedule to recharge. Develop coping skills to help you manage stress, so that it doesn’t compound. One example of a valuable coping mechanism is laughter, which can reduce anxiety and increase our intake of fresh oxygen. Try to find ways to laugh each day, as part of your self-care practice. You can even find laughter yoga exercises on YouTube.
2. When something is not quite right, recognize, acknowledge, and call it what it is: Stress. Anxiety. Overwhelm. Depression. PTSD. Whether it is a formal diagnosis from a care provider or a gut instinct that you have, it’s OK not to be OK. The pandemic is amplifying our national mental health crisis. Recognize and mourn your losses, no matter how big or small you think they are. Communicate openly and honestly about your current state of mind; don’t minimize or ignore your symptoms until they become intolerable. Share your concerns with your primary care provider, a licensed therapist, a trusted family member or friend, or a 24/7 hotline. If you are in a potentially life-threatening situation, call 911, or go to your nearest emergency room. Opening up and asking for help can be terrifying, but you are worth it. No one is alone here. Seek the support and care that you deserve and need.
3. Find your sense of purpose: Develop your personal W-H-Y? Find intentional ways to connect to your larger life purpose and learn to savor them. What are your volunteer efforts? What does your charitable giving list look like? Altruism drives a sense of purpose and is a recognized trait of resilient individuals. Try to integrate your work and life effectively for you. Strive to be a realistic optimist and, rather than focusing on the negative, hone in on what you can contribute to your community, region, state, or country.
4. Get connected: Establish and nurture a supportive social network. Who comprises your safety net? Whose safety net are you in? Help others to support and nourish you by building a social resilience community. Never be afraid to lean on your support systems, even if virtually. How did you build your support group? Do you have an online community? Develop positive and trusting relationships in which you can work together to endure and recover from stressors. By listening and hearing, we can be kind and compassionate to others when they need it most. Do a proverbial mitzvah!
5. Find your resilience role models: On a personal level, I derive such joy and inspiration experiencing the resilience of my immediate family members. As a South African, it will also never cease to amaze me when I consider the remarkable resilience shown by Nelson Mandela. His endurance and persistence in the face of severe adversity were coupled with his ability to show emotional regulation, empathize, build connections, demonstrate self-efficacy, and stick to his guiding moral compass through authenticity. His favorite poem was “Invictus,” written by William Henley, which ends with the powerful line, “I am the master of my fate / I am the captain of my soul.”  
6. Seek to constantly learn and improve: Be coachable and seek feedback that you learn from and act upon. Seek this feedback from those sources most likely to be helpful to you. Recognize that change can be good, however inconvenient or uncomfortable. View so-called “failures” as learning and improvement opportunities and embrace them; activate your action plan, rather than dwelling on what might have been.
7. Know what emotional intelligence looks like: Practice self-awareness by knowing your stress levels and noticing your emotions. Train your brain—build emotional intelligence, moral integrity, and physical endurance. To boost your emotional resilience, work on understanding, appreciating, and regulating your emotions, while consciously choosing your feelings and responses to avoid being reactive. Learn to become self-aware. This includes recognizing what drives your stressors. What pushes your buttons? Finding and sticking to your moral center may aid this journey.   
8. Find ways to relax and decompress that work for you: Some examples include spending time with friends, pursuing hobbies, cooking, meditating, and listening to music. Each of these can be enjoyed in groups or individually, depending on what you prefer. As one example, photography is an art that can be practiced in mindful ways, shared with colleagues, and even used as a communication and connection tool. It might even influence your choice of travel locations and online connections. Surround yourself with positive energy. Misery doesn’t love company—find new ways to manage or even avoid adversities and adversaries. Have an executable plan to eliminate your blockages.
9. Practice gratitude and self-compassion: Hardwire this into your daily activities list; it will help you to feel content. This might simply include journaling things that you are grateful for. You already possess a series of resiliency tools and have likely overcome adverse situations that you learned from. Your journey has already begun, and you have endured 100% of your worst days. Congratulate yourself for this.
10. Reflect: This can go hand-in-hand with journaling. Simply put, sit quietly with the events and feelings of the day and see what comes up. Committing to creating the time for reflection allows one to build and increase self-awareness (an important component of emotional intelligence), encourages learning, and opens doors to being more adaptable. For events that occur, consider what happened, how it made you feel, and what lessons or new approaches you learned from the experience.

Sharing the Recipe

As a leader, your resilience impacts your performance, as well as the performance and engagement of your teams. Stressed leaders engage in fewer positive leadership behaviors, such as enunciating optimistic visions, setting and overseeing goals, communicating confidence, clarifying roles, showing genuine appreciation, and recognizing performance. Stressed leaders can become passive—they step in only when needed, tend to avoid decision-making, and can be emotionally absent. These attributes get noticed and impact teams. Resilient leaders can keep calm under pressure and develop additional skills (a component of posttraumatic growth) in the face of adversity. Through self-reflection and feedback, resilient leaders have a keen sense of the main components of emotional intelligence.

Resilient leaders can also regularly assess their leadership effectiveness and styles, more readily responding to change and unexpected situations. Striving to learn and grow continuously, resilient leaders are often purpose-driven individuals—they can visualize their work effort as being meaningful. Resilient leaders cultivate relevant and helpful relationships in their internal and external work environments that support them through tough times.

Why Is Resilience at Work Important?

Resilience shapes the way employees respond to the stress of change. It also relates to work engagement, job satisfaction, and organizational commitment. Resilience is inversely related to the frequency and manifestations of burnout and can improve organizational and employee performance.

How Do We Recognize Resilient Behaviors in Others?

A spectrum of characteristic behaviors and skills is recognized under the resilience rubric. Many of these are also included under a larger umbrella of effective leadership behaviors. A person who manifests resilient behavior communicates clearly, thoughtfully, and consistently. Moreover, effective leaders may design a strategy for communicating and managing change that accounts for different stakeholders and their communication preferences. Resilient individuals are coachable, regardless of their position in a hierarchy, and many seek opportunities for learning and improvement. They are willing to embrace change, and, ideally, they’re skilled at managing it. Resilient individuals are comfortable saying, “I don’t know” (and “I would like to learn”). They know how and when to take bold risks or when to initiate new ideas. Similar to effective leaders, resilient individuals are willing to and do invest in the development and advancement of others.

Those with high levels of resilience are better equipped to cope with stressful situations. They tend to see change as an opportunity, are optimistic, adaptable, and realistic about realities, and engage colleagues for support. Resilient individuals possess emotional regulation skills and don’t allow stress to impede their functioning. They practice self-compassion to reduce harsh self-criticism, soothe difficult emotions, and find sources of motivation. Resilient individuals show cognitive agility, a difficult skill to develop, which entails shifting how one thinks about negative situations.

Let’s face it: It’s really difficult learning to become resilient. It takes time, persistence, effort, commitment, energy, and a drive to succeed. We do know that resilient teams are best served by resilient leaders. Now more than ever before, we need our imaging teams to function effectively. Our teams should be equipped with resilience to face ever-changing challenges and unanticipated adversities, and whether they are or not begins with us as leaders.

About the Author

This post was originally featured in ARRS InPractice.

Some days, it’s hard to recall what prepandemic life was like. Things have forever changed in light of this historic global event, and it’s vital to reflect and process these last three years. We’ve endured some of the most trying times of our careers, but we also have a bright future as a medical community ahead. You’re wondering what that might look like and how we can collectively “skate to where the puck is going to be, not to where it has been,” as Wayne Gretzky famously said.

COVID-19 precipitated a fundamental change in clinical service delivery, teaching, research, staff retention, employee wellness initiatives, and communications strategies. We amended workplace safety standards and practices, stood up and resourced remote teams, recruited trainees virtually, and transformed in-person grand rounds programs into digital ones. These are just some of the many efforts that we as a specialty undertook to protect our people, uphold our missions, and keep our teams employed. And while not all changes were novel ones, the pandemic catalyzed their implementation. We now have tremendous momentum to continue innovating, especially as we begin to emerge from crisis mode together.

Accelerating Change

Here at Beth Israel Deaconess Medical Center, we simply couldn’t have managed this public health crisis without our highly effective, efficient, and resourceful operational surveillance systems and teams. Some of these teams were in place before the pandemic started; they rapidly responded to the initial phases of COVID-19, then swiftly transitioned into a multidisciplinary incident command structure to assess, rethink, reinvent, iterate, and communicate our health care systems and strategies on a daily, hourly, and minute-by-minute basis. This collaborative structure operated in real time and kept our trains running, on schedule and on the tracks, far more often than not. Light started to appear at the end of the tunnel, and then, the alphabet of variants arrived. It soon became clear that we would never return to prepandemic normalcy. A fundamental shift had taken place in the way we delivered our services, and some of this change represented the necessary digital transformation many had envisioned long before COVID-19 struck.

So, what are our next steps? How can we effectively shift from a reactionary mode to one that is deliberate and purposeful? What structure will best support the necessary regrowth phase that will support our medical practices and organizations? Now is our time to be accelerators rather than incubators, to reinvent and rebrand our skills and clinical contributions, and to be thoughtful and strategic in the process. This is where the most strategic, imaginative, and operationally agile teams will lead the way and define our recovery. Those who embrace change and progress will be the best positioned to thrive. Lead the change. Be the change.

Building COVID Recovery Hubs

Let’s be the disruptive thinkers our field will be proud of. Define, then communicate your future radiology vision. Do this in an inclusive manner that involves all role groups. For such plans to be adopted and successful, leaders will need to continue to create forums for staff to weigh in, ask the right questions of their teams, listen to feedback, barriers, needs, and ideas, and provide other ways to share input, such as through short pulse surveys in a departmental newsletter or real-time polls during meetings. Ensure everyone’s voice is heard and incorporate major common themes into your plans.

We suggest constructing and resourcing a formal COVID recovery hub, which can house your postpandemic mission, vision, and recovery playbook. Appoint and support a multidisciplinary team to lead and own these pioneering transformation efforts. Who have you appointed to lead your radiology recovery, reinvention, and reengineering transformation? What does your “r⁴” portfolio look like? By answering these questions, you will help your practice continue to keep its staff and patients safe, deliver exceptional care, manage ongoing people and supply chain shortages, support staff morale and wellness, nurture remote teams, and effectively communicate and engage with a multigenerational workforce.

Reimagining Administrative Functions

As part of your COVID recovery hub, consider the roles, responsibilities, and constituents of your leadership team. Are you best positioned for your recovery? Now might be a great time to reimagine these elements and challenge the traditional hierarchy, as we work to flatten authority gradients, build diverse, inclusive, and multigenerational teams, and ensure that form follows function. Additionally, these roles have likely transformed out of necessity during the pandemic and might need to evolve to meet your practice’s future needs.  

Let’s be a little provocative: how can we identify the best person to be our “knowing exactly where the puck will be in 2030” portfolio leader? Actually, this is not a task for one person—and this is precisely why building and sustaining high-performing diverse and inclusive teams will become paramount and essential. Proudly establish your recovery hub, appoint a vice chair of recovery and reinvention to lead this effort, then establish and resource new portfolios to signal just how serious you are about recovery, regrowth, and reinvention. For example, have you considered the future of your remote teams? Based on national employee preferences, it’s clear that some level of remote work is here to stay. Perhaps, as part of a practice’s new digital innovation and transformation lab, it could create a remote workplace and team-building portfolio. Will your organization continue producing short video messages, digital newsletters, social media content, and academic webinars? What will your postpandemic communications strategy look like? Perhaps it’s a question for a newly formed digital communications and connections team. While these structures might not be novel in a large, digital-first corporate setting,they would be a progressive leap forward for many of our major academic medical practices.

Additionally, we all know that health care delivery has progressed to incorporate population health, cost reduction improvement efforts, care coordination and integration, and customer experience, among other important factors. Simply put, our aim is to deliver the highest-quality, safest possible care and experience at the most sustainable costs. This boils down to value, and who better to drive it than an effective chief value officer?We’ve certainly been talking about this value proposition for quite some time already. On a different but equally important note, we must think about how we will continue to support the health and wellness of our staff postpandemic, especially during our nation’s mental health crisis. Is there an influential and compassionate leader on your team who could become your chief wellness leader and drive these vital efforts to aid your entire team?

The structure of a leadership team should primarily relate to its intended function and purpose. Once you have reconfirmed your foundational core purpose, reimagined your vision and mission, and defined your annual goals, then form the team (and define their precise roles) that will help you reach your ideal future state. Energize your teams by including them in strategic brainstorming and planning sessions, imagining an exciting and successful future together.Designing a newoperational landscape is not a task for one person, which is why building and sustaining high-performing, diverse, and inclusive teams will be paramount.

The interesting exercise that we are all engaged in now is to define that future state. Has anybody considered a leader of a recovery and reinvention portfolio? Your entire team wants to contribute! Be inclusive and build diverse teams.

Mapping New Pathways

This is an era of posttraumatic regrowth. Reimagining your pathway should be an inclusive, aspirational, and even inspirational process. Be thoughtful and strategic when redefining your path forward toward the new normal you and your team aspire to achieve. Reengage and revitalize your most precious resource, your workforce. Recommit to safe practices, wellness initiatives, and high-performing team building. Reconnect your teams, and work to sustain these connections. Reimagine and rethink your strategic plan and goals, and start your new journey today. Those who will flourish and thrive will do this effectively, thoughtfully, and strategically; consider the long-term goals, map out your route, and take action. As you shift from managing operations to imagining the future, try to shift your focus from keeping the trains running to considering where new rails could be built. Periodically, it’s important to pause and ponder—to consider not only how trains can be better engineered, but also to contemplate whether train travel will be a safe and efficient customer choice in the future. That’s strategic thinking.

Let’s try to simplify. You’re done with reacting, reflecting, and responding. You’re starting to see some light at the end of this tunnel. You’re hoping that omicron is the last symbol of this pandemic alphabet. Now, more than ever before, is the time to look forward, plan your recovery strategy, and focus on building and sustaining innovation. The practices that are most likely to thrive are already thinking outside the traditional administrative oversight box. And they are moving ahead right now.

And, finally, find ways to share your experiences of this journey. We’re all traveling new paths and learning as we go. We must learn from each other’s successes and missteps, and there will be plenty of both. As we build our departmental COVID recovery hubs, we also need to design and build collaborative teams to communicate and interact with institutional, regional, and national COVID recovery hubs, to the extent they exist. These new systems must be capable of redefining and reimagining the future, so that we can all travel along the path of progress together.

It’s now time to be intentionally inclusive, as we commence this new journey.

About the Authors